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Attestation for 2015 Programs

 

Please complete your 2015 CSMS-IPA Commercial Attestation form(s) below.  If you have any questions regarding the process, please contact Rosemary Hokanson @ Rhokanson@csms-ipa.com or call 860-573-2580.  Thank you!

 

 

Attestation For: Form
Fill out this form if you are participating in the Commercial Pediatric Program. Click Here
Fill out this form if you are participating in the Commercial OB GYN Program. Click Here
Fill out this form if you are participating in the Commercial Adult Medicine Program. Click Here

ABOUT CSMS-IPA

The Connecticut State Medical Society - IPA (CSMS-IPA) is the largest and only statewide IPA in Connecticut and one of the largest in the nation. The CSMS-IPA is comprised of approximately 7,000 physician members. The CSMS-IPA is governed by a 27-member physician Board of Directors.

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CONTACT US

Corporate Office
127 Washington Avenue
East Building, Lower Level
North Haven, CT 06473
Phone: (203) 562-7228
Fax: (203) 624-6665

Operations Office
1 Corporate Drive, Suite 315
Shelton, CT 06484
Phone (203) 225-1291
Fax (203) 925-2652
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